As Delta Variant Takes Washington State, Latin Americans Face High COVID Risk
MALAGA, CHELAN COUNTY – Teresa Bendito-Zepeda and a few companions went door to door on a summer morning last month, coaxing farm workers at this migrant housing complex to a pop-up COVID-19 vaccination clinic up in an empty apartment.
They are the Madrinas de Salud, the godmothers of health, says Bendito-Zepeda, and they have a simple but intimidating mission: to help immunize as many Latinos as possible in Chelan and Douglas counties.
The work of the Madrinas has taken on new urgency as the highly contagious delta variant of the coronavirus takes hold in communities across Washington. Delta is estimated to represent more than 90% of new cases and is the source of a fifth wave of illness.
And the Latinos the Madrinas serve are the state’s largest ethnic minority – with the lowest vaccination rates among racial and ethnic groups.
“Wherever people are, we go,” said Bendito-Zepeda.
Statewide, 43% of Hispanic residents have received at least one dose of a COVID-19 vaccine, compared to 57% of all residents.
In some counties, particularly east of the Cascades, the rate is lower. In Adams, where nearly two in three residents are Hispanic, only 34% of them have received at least one injection; in Franklin, where just over half the population is Hispanic, only 32% received at least one dose. The low vaccination rate reflects that of the larger populations of the two counties.
Latinos have historically faced barriers to healthcare, including a lack of health insurance, language barriers, and fear of deportation which experts say contribute to high exposure to COVID-19. And, like the general population, Latinos are subject to misinformation about vaccines via social and personal networks.
Calculating the risk for Latinos, nearly a million people in Washington, is certainly not straightforward. During the pandemic, Hispanics accounted for 29% of COVID-19 cases, according to the State Department of Health (DOH), although they make up only 13% of the state’s population. Hospitalizations for the disease are also disproportionately high. But Hispanics are slightly under-represented among those who die, at 12%.
Another aggravating factor contributing to risk for Latinos is age. About 25% of Washington’s Hispanic population is under the age of 12 and therefore is not eligible for COVID-19 vaccines. In contrast, the percentage of whites and Asians under 12 is 13%. For black residents, it is 17%.
Dr Leo Morales, co-director of the Latino Center for Health at the University of Washington, says the age difference is critical.
“Any age is vulnerable if you are not vaccinated,” he said. “So even though young people have a lower risk of serious illness and disease transmission, they are still vulnerable to COVID unless they are vaccinated. Viruses don’t care about your age.
There is a real danger to the unvaccinated, whether they are eligible or not, as the delta variant appears to have started to rampage across the state.
The DOH reported 600 statewide hospitalizations last week, a 20% increase from the previous week. The percentage of positive tests soared to 5.5%, from 2% a month ago. Hospital occupancy rates are at their highest level so far in 2021, the DOH said. More than 94% of all cases, deaths and hospitalizations for ages 12 and over between February and June have been linked to people who were not fully vaccinated.
“This is going to hit the Latino community the hardest because they are the least vaccinated,” Morales said.
Barriers to care
Latinos have long been at a disadvantage in the U.S. health care system, Morales said, and it was no surprise that their vaccination rates were lagging behind.
“Latinos are disconnected from the health care system for many reasons,” he said. “They don’t have regular health care providers, or they can avoid it if they think it threatens their ability to live in this country. And the cost of health care is formidable and there are barriers too. cultural and linguistic which add to their hesitation.
High infection rates and low vaccination rates among Latinos illustrate great inequalities here and nationally, said Matias Valenzuela, director of equity for public health – Seattle & King County.
Latinos are doing jobs deemed essential during the pandemic, he said, which can accelerate the spread of the virus. They are also more likely to live in multigenerational homes than whites or blacks, although less likely than Asians or Native Americans. Multigenerational households were prioritized for immunization when supply lagged behind demand.
In King County, infection rates among Latinos are four to five times higher than those of white residents, Valenzuela said.
“Access to a good education, to good paying jobs, to good housing, all these kinds of things are essential for people to be able to function, live and make good decisions,” said Valenzuela. “When you run into these issues and deal with COVID at the same time – it’s no small feat. “
These barriers can be chipped. Medical Teams International (MTI) helped organize the Chelan County Vaccination Clinic with Bendito-Zepeda and the Madrinas. The Portland-based aid organization began testing farm workers for COVID-19 in the spring of 2020.
Its continued presence in these communities has made it easier for MTI to manage mobile vaccination clinics to reach largely Latin American migrant workers.
“We have become a trusted name in providing high quality services and being able to respond quickly to both testing and immunization needs,” said Leslie Aaron, Washington COVID-19 program manager for MTI.
Another battle for public health officials and advocates is misinformation about vaccines. Morales is aware that, as with other racial groups, there is some reluctance towards vaccinations among Latin American communities due to misinformation.
“I don’t know how much religious reluctance there is, but we are hearing about it,” he said. “There is apparently a lot of social media coming from Latin America. Priests who have spoken out against vaccines.”
He is working with other groups to counter the spread of disinformation by hosting online panels in Spanish with religious leaders from both sides of the mountain, which will be broadcast via radio, Univision and Facebook live.
To reach Latinos, it is essential that they have easy access to COVID-19 vaccines and that these vaccines be provided by other Latinos or Spanish speakers, Bendito-Zepeda said.
“I think it resonates with people,” she said. “I’m here with you and I’m not going to lie to you.”
Anna Zamora-Kapoor, assistant professor of sociology, medical education and clinical sciences at Washington State University, said it was important to encourage people to embrace vaccination.
Latinos are generally not reluctant to get vaccinated and will do so if access is easy and if they can ask questions of a Spanish-speaking provider, Zamora-Kapoor said.
“If I had to run a campaign to promote the COVID-19 vaccine, I would say something like, ‘the best gift for your family is to get the vaccine,’” she said. “The idea is to emphasize that the vaccine not only protects you, but also your family and those around you, those you love.”
Sick, hesitant, then convinced
María Dolores Herrera, 43, from Spokane, is concerned about the safety of vaccines for herself and her seven children. She was worried about the side effects and how they would affect her diabetes.
The lack of information in Spanish and accessible to her only increased her concerns.
“A lot of times it feels like the doctors don’t really care about us Latinos, so we only go there if we really have to,” said Herrera, who works in cleaning the houses.
Herrera and some of his family contracted COVID-19 in December. They only left their homes to shop for groceries, other necessities or to work, she said. They still don’t know how they were exposed.
Although she feels ill, Herrera has gathered enough strength to cook and care for her sick family. Every morning she would wake up to brew enough herbal tea in a pot to last all day.
When she became eligible for the vaccine, she assessed her options. Some friends and acquaintances have tried to talk him out of it, she said, expressing concern over some “weird” theories, including that the vaccine contains a government tracking chip.
“There was just a lack of information overall that probably gave way to stories like this, and it still happens,” she said.
As she debated getting the shot, several Latino organizers encouraged her to get the shot and answered all of her questions.
But her concerns remained and her family continued to isolate themselves even as the state rolled slowly, she said.
It was only after a family friend received his vaccine and remained healthy – and alive – that Herrera and her family decided to go to a vaccination clinic in June at Spokane Community College. .
“I was always scared, but I thought about how life just has to go on and we can’t do that by living in fear,” she said.
She still struggles to let her eligible children get vaccinated. But candid conversations with Latino leaders helped her realize that it was also in her children’s best interests to get the vaccine.
Successful awareness raising
Dr Mabel Bodell, a nephrologist at Confluence Health, who has worked with Bendito-Zepeda, began contacting Latinos in the Wenatchee area early in the pandemic for testing and other needs stemming from infections. She understood that she would have to work with the community once the vaccines were available.
In December, she started the Yes! ¡At the vacuna! (“Yes! To the vaccine!”).
“We have to tell a story. We really have to tell them about our experiences, and sometimes it takes several times… It takes a lot of effort, once, twice, three times to talk about it and make sure they have the right information to make the right decision. ” , said Bodell.
The efforts seem to be paying off. Bodell said that in March and April 2020, more than 50% of COVID-19 admissions at Confluence Health’s Wenatchee Hospital were Latinos. This figure is now between 5 and 8%.